PACs are back :(

[Christina L]

Susan,

Thank you very much for your post regarding sotalol. I got on the internet and read the same thing as you told me - that sotalol shouldn't be administered for the first time without monitoring. I called the cardio on call tonight and he said that it was a very low dose and shouldn't be a problem - told me that there really are not any good medications to control rhythm problems. Is that true? He said to sit down again with the cardio I saw today and discuss my concerns, but I told him that I will wait this out and see if the PACs will go away on their own. No more sotalol for me - it went into the garbage can.

Again, the doc today did not want to prescribe Ativan because he feels I could become addicted, yet he prescribes a heart medication that can cause cardiac arrest or send you into other types of arrhythmias. I don't understand doctors at all!! What is worse, being dead or being addicted to an anti-anxiety medication? Ativan was working for the PACs. I am pretty bummed tonight. Pretty discouraged. Pretty scared of this whole heart thing that I am deep into.

Sherry,

Thanks for your post. I notice my PACs at rest and they do seem to go away when I am up and active. I so admire all of you who are many years out from heart surgery and lead such active, happy lives - so matter-of-factly - I wonder if I will get to that point - where my heart problems will just be a part of my life, not ALL of my life.

Hopefully, a good night's sleep and a brand new morning will bring a lift in my spirits. Thanks for listening.

Christina L.

 

[ticktock]

Christina
Just a thought here.... but I'm thinkin' that Gatorade has a bunch of sodium in it... are you on a restricted diet? Over 30 years of PVC's and PAC's has taught me that you are absolutely right about dehydration, also drinking very cold liquids will cause it, cokes or anything with caffeine, sometimes hiccups start them..... Another one for me is emotional upset, particularly crying (not that I cry much..... .)....

Maybe watch and see if something in particular is causing them. They gave me Xanax for about 2 years, til I got tired of taking it. Quit and started keeping track. Cold drinks are the WORST! I mean as in Decaf Tea, Soda, etc. Sounds like you are on the right track.

Prayers that they stay in control!
mindy

 

[ALCapshaw2]

Hello Christina,

Sorry you are having more trouble with this nuisance (PAC's). I've been reading your thread with great interest since I too have been having PAC's more frequently of late, even (or especially) at rest. My cardio ordered a '30 day loop monitor' to see if we can find out more about what is going on. In the mean time, I skipped my usual morning cup of Hot Chocolate and voila, NO PAC's after 3 days of regular events, even with no exercise.

So far, I have determined that PAC's can come on following Sleep Deprivation, STRESS , and CAFFEINE. Watch out for hidden sources of Caffeine, such as CHOCOLATE. I LOVE Chocolate. Oh well, there goes another pleasure in life. So it goes.

One more 'cure'... I have noticed that when I feel my pulse in my neck (and hold my breath) that they often STOP, at least momentarily. Another good question for the Doc's (like THEY would know what's going on )

Hope all goes well for you Christina.

A fellow sufferer,

'AL'

 

[bvdr]

Hi Christina,

I've had so many kinds of arrhythmias. They started actually years before I was ever diagnosed with heart problems. In the back of my mind I knew something was amiss but just didn't want to get into it. It probably didn't help that I have always been very independent and just never went to a doctor unless I had exhausted everything I could try first. I knew PACs are very common and, except for being annoying, are almost unheard of to directly lead to anything dangerous. When I would get into a sustained abnormal rate or rhythm I would go through a little mental checklist. I would ask myself about accompanying signs such as increased shortness of breath, sweatiness, dizziness, pain, or weakness. I would feel for a pulse in my wrist. I always had a pulse so I knew my heart was able to maintain sufficient blood pressure to pump blood throughout my body. I would quickly review my recent caffeine, dietary and fluid intake. (MY blood pressure medicine sometimes would make my potassium dip and I knew that I had more erratic beats during that time.)

As strange as it may sound, I even ran a few EKG monitor strips when I worked in the ER and didn't see anything on them that really threw up a red flag. This went on for years and I even had several non-heart related surgeries during that time with pre-op EKGs that were acceptable. This was "normal" for me. I did not know I had a history of rheumatic fever.

A few years ago I began noticing some shortness of breath and some more prolonged episodes of very rapid arrhythmias that lasted longer and longer. I knew the type of work-up that would ensue if I went to the ER. Once I was driving past the hospital with newly purchased groceries and in the middle of one of these episodes. I was feeling lousy enough I might have stopped had it not been for the frozen foods in the car. I still had a good radial pulse so I didn't truly consider myself to be in any dire emergency. Believe it or not, other ER nurses react very similar to how I did. I guess our threshold for "emergency" for ourselves differs from the norm.

Then.........the fatigue set in. The arrhythmias started being more troublesome. It wasn't something that I could ignore any longer. I had self-diagnosed atrial-fib by process of elimination and knew that this was something that must be documented and treated.

This by no means is the recommended route for treatment. It just may explain a little why I ignore most out of sequence beats. My hesitance to put myself into the "cardiac patient" mode didn't change the course of my heart disease at all.

For me, if the abnormal rhythm is putting me at risk for something potentially more dangerous such as a different type of rhythm, a clot or a reduction in cardiac output, then I will take something to prevent or control it. I reached that place before surgery and the drug that finally seems to have helped is flecanide. It is suppressing my atrial fib and thus improving the way I feel.

I'm sorry this ended up being so drawn out but I guess all of this is just my way of saying that sometimes even though things are bothersome they arn't always dangerous.

If you just can't get comfortable feeling these beats then you might have to be on some medication like the sotolol but just weigh you risk/benefit and ...try not to worry so much .

 

[Christina L]

Thank you Mindy for the information. It is very helpful. I am feeling somewhat better this morning, but still very stressed and bummed.

Al, you have always been such a kind person - I can feel it coming through on your posts. Sorry to hear that you and Mindy both have had to deal with PACs also. They really are not the end of the world, I know that, it is just that they are irritating and when a person is post heart surgery, they are very stressful - I think something is going wrong with my mitral valve repair.

I have come to the decision that I need to take a break from the VR.com board. I am becoming obsessed with it - feeling I need to help everyone else coming onto the board. I think there comes a time when a veteran of the board needs to go away for a while. This is my time. I need to get my mind on other things. It will be HARD - talk about an addiction!! I will miss everyone a lot and if anyone wants to send me a post with a question, you can send it via my private E-mail.

Okay, this is it! I am going - AFTER I read some more posts that is - then I am gone for a while. Not for good.

Thanks all for all your help these past eight months. A special thank-you to Ross - you are a gem. There are many others and you know who you are, whom I am forever indebted to also. You have become dear friends and I am hoping to get to the reunion in October to meet many of you.

I wish for all of you continued good health and much happiness. Live for the moment - carpe diem.

Love,
Christina L.

 

[bvdr]

Christina,

I will truly miss you if you disappear for a spell. Maybe just a short "vacation" is all you need. You have so much to contribute and have helped so many by being here. Please don't stay gone for very long.

 

[Gemma]

Hi Christina,
I know exactly what you mean about taking a break - I know it was my boyfriend and not me who had the valve replacement but I sometimes think I'm getting a little obsessed and seem to be doing enough worrying for the both of us!!!
I've been following this thread with interest - Jim has had what I assume are PVCs (you can hear his aortic valve click faster on the early/ectopic beats which is what led me to this conclusion - if we could actually get someone to tell us the results of the holter monitor he had done in March it might help ) Anyway, to save writing it all again his ectopic beat/sotalol story is here:

http://www.valvereplacement.com/forums/showthread.php?t=7543

So you can see we're not great fans of sotalol either, although it does have pros as well as cons. When Jim was first given it he had to stay in the hospital for 3 hours so they could check his BP, then released when they were happy with him.
It's interesting your cardio said to take more exercise - Jim finds his heart beat is normal in the evenings after he's been exercising. Almost makes me feel the sotalol slows his heart down too much and it needs a kick of adrenaline, courtesy of a bit of exercise, to get it back to normal.
Also interesting your cardio told you to only take the sotalol as needed. Hmmm.... maybe worth Jim asking about. Although he was originally put on it to slow his heart down, in the last couple of months, as he has got stronger and his heart rate naturally slowed, these ectopic beats at night are his only rhythm problem. Perhaps he doesn't need it all the time.
He's stopped drinking anything with caffeine and tries to avoid stress - easier said than done sometimes . But exercise, and keeping busy with other things, help both physically and psychologically.
What's my point? I have no idea!!! Maybe don't throw the sotalol out just yet. IF you get PACs again maybe give it a go, if it doesn't make a difference don't take it again. Personally I would be reluctant to take sotalol -for the reasons you've mentioned - but everybody's different. It must help some people or it wouldn't be out there on the market .
I'm going to see if I can convince him to see his cardio before his next scheduled appointment in November, so he can talk through his concerns and with any luck stop or change the sotalol. I don't think either of us can go another 5 months with all this night-time stress.
Gemma.